Tuberculosis in diabetic patients in Tanzania.
During a 1-7 year follow-up of 1250 African diabetic patients at Muhimbili Medical Centre, Dar es Salaam, 68 (5.4%) were known to have developed pulmonary tuberculosis and two (0.2%) spinal tuberculosis. In 18 (25.7%) of the 70 patients tuberculosis was diagnosed prior to the diagnosis of diabetes, and in 32 (45.7%) after the diagnosis of diabetes. In 20 (28.6%) patients tuberculosis and diabetes were diagnosed at approximately the same time with most presenting with symptoms of diabetes. The prevalence of tuberculosis was greater in the young, in those with a low body mass index (BMI), in patients with insulin-dependent diabetes mellitus compared to those with non-insulin-dependent diabetes mellitus (9.0% vs 2.7%) and in those whose diabetes was poorly controlled. Seventeen (24.3%) of the 70 patients are known to have died. Pulmonary tuberculosis may progress rapidly and a high index of suspicion is required. It remains a significant cause of morbidity and mortality among diabetic patients in developing countries.
Swai
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AB
Department of Medicine, Muhimbili Medical Centre, University of Dar es Salaam, Tanzania.
McLarty
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DG
Mugusi
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F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013636:Tanzania / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000453:epidemiology* / Q000401:mortality